Parents’ Distrust of Vaccines May Be Even Harder to Counter Than We Thought

Despite overwhelming scientific evidence showing that vaccines are safe and effective, many parents have become skeptical. (Vaccines via Shutterstock)

Though there is a great deal of scientific evidence to prove that vaccines are safe and effective, many parents in recent years have become skeptical of the childhood immunizations designed to prevent illness like measles, mumps, chickenpox, and even the flu. Efforts to encourage these parents to change their minds have most often focused on correcting the misinformation on which these beliefs are thought to be based. A new study by social science researchers, however, suggests that this approach may backfire.

Much of the distrust of vaccines can be traced back to a 1998 study in which British researcher Andrew Wakefield looked at the records of just one dozen autistic children and determined that the MMR (measles, mumps, and rubella) shot was the cause of their condition. The medical community was shocked by this assertion and many did not believe the findings (especially because the study was so small). It the coming years, a number of researchers attempted to recreate the study and no one could confirmhis conclusion. Moreover, numerous other studies found no link between vaccines and autism, yet the popular press had already seized on the data, parents had been sufficiently whipped into a frenzy, and anti-vaccine groups and websites began sprouting up everywhere.

By the time the news hit in 2011 that Wakefield had a financial motive for coming to the conclusion that he did and that there was evidence that he had deliberately falsified information, the damage to the reputation of not just the MMR but all vaccines had been done. While public health experts scrambled to clarify the misinformation of the previous decade, anti-vaccine groups and celebrity spokespeople like Jenny McCarthy continued to suggest, despite evidence to the contrary, that vaccines were unsafe and led to autism. The results were frightening as the percentage of children who got vaccinated plummeted, and cases of long forgotten illnesses like mumps surged.

Those of us working in the sexual health field were also affected by the growing distrust as the vaccines to prevent the human papillomavirus (HPV) were released during this time. The HPV vaccine would have been a bit of a tough sell even without the doubt surrounding other inoculations, because parents sometimes fear that prevention efforts against sexually transmitted diseases—whether in the form of shots or condoms—will increase sexual behavior. Moreover, the Centers for Disease Control and Prevention (CDC) suggests that the shot be given starting at age 11 to ensure that all three required doses have been received before a young person becomes sexually active. Traditionally, parents don’t like to think about their children as even potential sexual beings, especially at such a young age. For these reasons and others, just 33.1 percent of girls ages 13 to 17 had received all recommended doses of the vaccine by 2012. (Though the CDC does now also recommend that boys be vaccinated, the early push was limited to girls).

So while other public health experts have spent the last decade trying to correct the misinformation about vaccine safety and the link to autism, sexual health experts have been providing similar information designed to reassure parents about the HPV vaccine specifically; it is safe and effective, it does not cause sexual activity, and it does prevent cancer. If this new study is correct, however, we may all be doing it wrong.

Researchers at Dartmouth College in New Hampshire surveyed over 1,700 parents to determine their beliefs about vaccines. Specifically, they wanted to know if the parents believed the idea that the MMR vaccine caused or could cause autism. After identifying the parents who believed this myth, the researchers tried one of four methods commonly used to correct such misbeliefs. Parents were either given information by a health authority that explained there was no connection, given information about the three diseases that the MMR vaccine protects against, shown pictures of kids suffering from these diseases, or told a story about a baby who almost died from the measles.

After being given this positive information about the vaccine, parents were less likely to believe that the MMR caused autism. Don’t get too excited, however, because the good news ends there. Despite their new-found faith in vaccines, these parents were less likely to say they would vaccinate their own child than they had been at the start of the study. When the study began, those parents who were strongly opposed to vaccines said that at best there was a 70 percent chance they’d vaccinate their children in the future. After being given the pro-vaccine information, this went down to 45 percent. (The study just measured intent to vaccinate, it did not follow the parents or children to see what actually happened.)

The researchers say further studies are needed to pin point the cause of this reaction but they think it is linked to self-esteem and self-image. If you are somebody who believes strongly in the link between autism and vaccines and you are presented with information that suggests your beliefs are wrong, your self-esteem and self-image may be shattered. One natural reaction to this is to dig in your heels, stick to your beliefs, and start looking for proof that you were right all along.

Lead researcher Brendan Nyhan explained to LiveScience, “We suggest that people are motivated to defend their more skeptical or less favorable attitudes towards vaccines.” Nyhan noted that as of yet we don’t really know what works to change their minds and said that as we search for new methods, “We shouldn’t put too much weight on the idea that there’s some magic message out there that will change people minds.”

I had my own experience trying to craft a persuasive argument to a skeptical parent just last week. We were sitting in the waiting room of my pediatrician’s office noting how different it was to bring a 3-year-old who was dancing around the waiting room loudly (me) and a 14-year-old who was curled in a chair eyes planted on her phone (her). The office assistant came up and gave her a brief written description of the vaccines her daughter was scheduled to get but said that it was obviously her choice. She held up the papers one after the other and said, “We’ll do this one but let’s hold off on this.” The nosy sex educator in me went on alert. I knew it had to be the HPV vaccine. I looked at her inquisitively and hoped that since we’d already been chatting, she would tell me what had just transpired. She picked up the cue and explained that she’d been intending for her daughter to get the HPV shot at this visit but just before she’d left the house she had checked email and a headline came through claiming a new study found that very vaccine unsafe. I asked her for details but she had none because she hadn’t read the article yet, just the headline. Still, she said, it seemed like a sign from the universe.

Despite the fact that it was really none of my business, I feel strongly about the benefits of the HPV vaccine (see this article for more) and could not let the chance to change even this one parent’s mind slip away. I scrambled for the right messages, facts, and tone. I tried to explain my “credentials” on the subject. Then said from all the research I’d done it was a really safe vaccine and added that it had been shown to be working, which was great because pretty much everyone our age has HPV. I tried to stay away from too much detail lest I sound like I was launching into a prepared diatribe. Ultimately, after making just a few points in the vaccine’s favor, I agreed that it was weird she should see that email at that very moment and said I could understand her seeing it as a “sign.” I ended by telling her she should talk to the regular doctor (who was out that day) because I know he is very pro-vaccines and she undoubtedly trusts him more than some random stranger in the waiting room who claims to be an expert.

She did not get her daughter vaccinated that day, and I will never know whether she does in the future. Still, I wonder whether my words had any impact. And after this study, I wonder if any words could have.

Though I find the results of this study—and the human nature that they spotlight—fascinating, I hope they are not too discouraging to those dedicated public health professional who have spent the last decade trying to convince parents that vaccinating their kids, whether against a host of childhood illness or HPV and cervical cancer, is the right thing to do. Yes, we just found out that it may be even harder to change somebody’s mind than we thought, but we have to keep on trying.

If you are somebody who believes strongly in the link between autism
and vaccines and you are presented with information that suggests your
beliefs are wrong, your self-esteem and self-image may be shattered. One
natural reaction to this is to dig in your heels, stick to your
beliefs, and start looking for proof that you were right all along.

It’s called cognitive dissonance. Saying this like it’s new information is like a breaking news story that says water is wet. :-/

There will always be a subset of people who cannot handle having their worldview challenged. Unfortunately, they seem to be a vocal minority … and I consider those in the discussion at hand responsible for the resurgence of numerous diseases that had previously been eradicated by herd immunity. These anti-vaxxers are a public health menace.

cjvg

I respectfully disagree. The safety data is not as convincing as you might believe.
20 years ago I worked at a private practice with a retired cdc doctor and point blank asked him if he would vaccinate, after much hemming and hawing and ducking responses he admitted he would not but quickly mitigated that by claiming that was only his personal decision.
Currently the Australian cdc has halted the Gardasil vaccine for safety concerns and 15 years ago japan has forbidden the dtap vaccine to children under the age of 2 to reverse the increase in sids

bitchybitchybitchy

Citing judicial watch taints your argument.

cjvg

Because one site invalidates everything else?!
Not exactly what I would call above board debating !

Any other real arguments you would like to use to refute what I just said

bitchybitchybitchy

I agree that we should be cautious, but I think that vaccines have valid uses to protect public health.

cjvg

I never disputed that, if you actually read what I wrote you would have seen that.

My argument is that we can not insist on sanctity and right of ownership of our own bodies if we have no qualms about forcing others to take medicines they do not want to take!

bitchybitchybitchy

I said that we were going to disagree.

Expatmom

Samuel Clemens said, “It is easier to fool people than to convince them that they have been fooled.” These parents should never be treated with kid gloves. They should be made to admit that no evidence will make them change their minds. It should be pointed out to them that, using their reasoning, they would prefer to be the parent of a dead child than an autistic one. This should be typed up & the parent made to sign it. Pediatricians need to be bolder. The CHILD is the patient & vaccines shouldn’t be a menu handed to brain dead, phobic breeders.

lady_black

Very bluntly stated, but I feel the same way. It’s child abuse.

red_zone

OUCH.

But there seems, to me, to be some sad ring of truth to it. There is no stigma attached to someone who’s child died of illness, yet stigma aplenty to a child with autism.

cjvg

A healthy, mature immune system requires an equal balance of cellular (inate) and humoral (learned) immune system responses so that inflammatory responses do not remain unresolved and cause chronic illness. A disruption in immune function can lead to development of allergy and autoimmune disorders. Vaccination does not exactly mimic the natural infection process and often by-passes cellular immunity in favor of humoral immunity.

There have been persistent reports of development of autoimmune disorders and allergy after vaccination. Most pediatric neurologists when pressed acknowledge that vaccination, including use of vaccines for smallpox, rabies, influenza, mumps, measles, tetanus, polio and pertussis, can and does occasionally cause neurological complications that can lead to permanent brain dysfunction.

This is not an heretic view and well acknowledged by the CDC and the fact that 10% of the money for each vaccine goes to support the The National Childhood Vaccine Injury Act of 1986

Most members of the medical community believes that the risk of serious injury or death from vaccine preventable diseases is greater than the risk of injury or death which can be caused by a vaccine. However, recognition of and concern about the risks of vaccine preventable diseases does not diminish our need and responsibility to acknowledge the need to minimize vaccine risks.

The challenge today is for parents, physicians, scientists, manufacturers and health officials to recognize the risks of both the disease and the vaccine and work to protect the health and well being of every child.

Currently there is a gap in medical knowledge in terms of doctors being able to predict who will have an adverse reaction to pertussis vaccination, and who will not.

Considering all these things, it is clearly unethical to deny a patient the right to consent to a treatment for which they would suffer the consequences.
No one should be mandated to undergo medical treatment for the benefit of another, regardless of how much you believe it is beneficial!

Renee Goodwin

The children with insufficient immunities to allergens are also probably wrapped in bubblewrap at birth, with even the families’ pets sanitized on a daily basis, if children are not exposed to pets, other allergy triggers and dirt, their immune system will not develop properly.

red_zone

If your child doesn’t get vaccinated and later contracts a disease like polio, measles or whooping cough, who’s to blame? These are NOT little things; they are fatal.

cjvg

Even if a child is inoculated that is by no means a guarantee that they will not come down with these diseases.
Most vaccines have only a 60% effective rate at best, they are also not effective for live most range from 5 to 10 at the outside 20 year immune protection.

Pretty much every adult above 40 is a raging disease vector unless they had the disease in question.
There are many many many more adults who never had the disease and who’s vaccines are severely out of date then that there are children who where never vaccinated!

The whole herd immunity theory is complete nonsense unless the US and every other county that immunizes start addressing that blatantly ignored fact.

Child hood diseases are only called that because most used to get them in childhood. Since that is no longer the case these can no longer be considered just a childhood disease, adults can carry, spread and suffer from that just as easily and usually much more severe!

Renee Goodwin

or we could have schools that are only for vaccinated children and schools for children that have not been vaccinated, I think Darwin’s Award elementary school would have an appropriate ring to it for the unvaccinated childrens’ school

cjvg

Then please start mandating the forced inoculation of everyone over 40 since this is the largest unprotected disease vector in the US and beyond!

Renee Goodwin

And how many adults over 40 are unvaccinated? Let’s see your verifiable statistics, because anyone over 40 is more likely to have had all of their vaccinations than people born in the last 10 years.

cjvg

I did NOT say they where unvaccinated, what I did say is that their vaccinations already are so fart out of date that they are now unprotected if they never had the actual disease as a child!
Every adult over 40 who did not have the disease and never had a booster shot for all childhood diseases they never had is currently completely unprotected!

Every single research ever done on vaccine efficacy shows that at best only 60%of those inoculated will form anti bodies (that is the protective component) and at the very very best this will only last 20 years. More common are the efficacy rates of 30-54% and 5 to 10 years! So unless they actually had the disease (those anti-bodies last a life time) they are the largest disease vector we have in the US population!

Very few adults take booster shots for most common child hood diseases so a much larger part of the adult population is unvaccinated and unprotected then the percentage of children that are unvaccinated!

Interesting to know is that obstetricians have the lowest rate of current vaccinations (!) of almost all medical doctors, and the highest rate of direct exposure to newborns, young children and their expectant mothers!!

Obviously the accusation that the 5% of children unvaccinated or partially vaccinate damage herd immunity is very misleading when we gleefully ignore the enormous number of adults who are not protected

The point of the matter is that you DON’T attempt to convince these people about the safety of the vaccines. The law should force them to get the vaccines, PERIOD. In my state, your child will not be getting into school without them, and that’s that. I don’t even believe in religious exemptions after a recent measles outbreak caused by unvaccinated children. I got all the usual childhood diseases because there were no vaccines. Last summer I had a terrible outbreak of shingles which I wouldn’t wish on my worst enemy. That’s a consequence of having had chicken pox as a child. Will the vaccine prevent all cases? NO. My son got chickenpox and he had the vaccine. But it will prevent most of them, and more importantly, it’s not only YOUR child that is protected. Rubella is very dangerous to the fetus of a pregnant woman. An adult can transmit pertussis to an unvaccinated infant. When it comes to HPV, it’s not the parent who will contract HPV and be at risk of cervical cancer later in life. Since most people will become sexually active at some point, HPV vaccine should be given. It’s a common infection, so common as to be the norm.

Shan

“Rubella is very dangerous to the fetus of a pregnant woman.”

So is chicken pox. My GP, when I told her I was planning another pregnancy, made sure I got a course of vericella vaccine because even though my older child had been vaccinated, he was at prime chicken-pox-catching age and I’d never had chicken-pox myself. I presumed I was immune but bloodwork showed I had no antibodies.

(edit) And, yes, it’s still possible to get a disease after vaccination but the chances go way down. ESPECIALLY WITH HERD IMMUNITY, for Pete’s sake. The anti-vaxxers who think they can skate by because “everybody else has been vaccinated” are idiots putting not just their own kids at risk but OURS as well.

lady_black

Good for you. You did the right thing. I also got the adult pertussis vaccine so I wouldn’t pass it to my granddaughter. It’s the right thing to do.

Shan

I loved my GP. She took care of my son from the time he was about 2 and saw me through the birth of my daughter several years later. On vaccinations, she was a pretty hardcore proponent of them and told me that she thought parents not vaccinating their kids was pretty much tantamount to child abuse.

My new GP (we moved)…I asked her about the HPV vaccine for my kids a while back but she was a little cagey on it. She thinks it’s a good idea but suggested waiting a while until its safety record gets a bit stronger.

lady_black

Yes it IS tantamount to abuse, and that was the point of my post. And it’s not just abuse of YOUR children if you fail to vaccinate, but of others as well.

lady_black

P.S. I would still insist on the HPV vaccine, by age 11 at the earliest.

cjvg

It is not that simply, if you contend that you respect a womans ownership of her own body and medical choices you can not turn around and state that the federal government should have the right to peoples bodies and their medical decisions without consent

Also the best preventative is still safe sex as in a condom
According to the most recent research the two types covered in this vaccine only account for 30% of all HPV infections, although these 2 types are found in about 70 % of vaginal cancers.

However, this is NOT the same as claiming that the vaccine will prevent 70% of vaginal cancers, although that is the claim routinely used to make the sale to a
patient.

In other words, 30% of the HPV infections are caused by these 2 types, and research clearly shows 90% of HPV infections will clear on their own without additional treatment or other consequences.

Of the 10% of females who will not be able to clear this infection, some will
develop vaginal cancer (there are no studies that show what the percentage of
females with chronic HPV infection who get vaginal cancer is) for some reason (!) the makers of Gardasil and the CDC are not interested in this information

So of those 10% who do develop vaginal cancer, 70% of the tumors have these 2 types present! but lets not forget only 30% of HPV infections are the strain that is covered in the vaccine and 90% of infections clear up on their own without leading to cancer.

So obviously just relying on a vaccine causes a false sense of security!
It is much better to rely on information and education and condoms. If your daughter decides she wants the vaccine then she is still able to receive it after a clear HPV test at 18 when it is her decision.
On top of that the company has no clear answer about how long the protection would last and at what point a booster needs to be applied

lady_black

I’m sorry. When it comes to issues of public health, I cease to be a fan of “choice.” Notice I didn’t say that HPV vaccine should be required by law. I said it was a good idea. You can’t catch HPV through casual contact. That makes someone who doesn’t get vaccinated not a public health risk, hence it’s a choice. I might believe it’s foolish not to get Gardasil, but it doesn’t put the public at risk.
If you don’t vaccinate your children against polio, MMR, chicken pox, mumps, pertussis etc., you are making your children a public health risk and I believe it to be tantamount to abuse. I don’t believe that should be a choice where it isn’t contraindicated medically.

L-dan

I’m mostly with you here. I respect the folks looking at the rather large schedule of vaccinations in the early years who go ‘whoa…too much, can we spread this out a bit more?’ Because it really is a lot and some of them are more important than others, etc. But the biggest ones should be able to be fit in by the time kids are headed to school. The tough part is what to definitely squeeze in before heading to day care, which can start in a kid’s first months.

I suspect the schedule is built as it is partly to get as many kids as possible vaccinated when doctors know they’ll have limited chances with many of them, and partly because you get “new vaccine x can be given at y weeks,” without real attention paid over the years to how many have fallen into that week y.

It’s the ‘no vaccines at all, ever’ people that boggle my mind. That’s not remotely an educated choice balancing the risks and rewards to one’s kids and those around them. Plus, you’re then raising a future unvaccinated adult…who could *really* be in trouble if they run into some of these diseases.

Chicken pox I’m watching curiously. I’m from the generation where nearly everyone just had it as kids and are therefore most got lifelong immune with some percentage stuck with shingles flareups as the cost of that immunity. The vaccine seems to not confer lifelong immunity which means it remains to be seen how much of a problem that’s going to become, given the usually poor rate of adult booster coverage. I sort of wonder if the incidence of adult chicken pox (generally more severe than in childhood) will end up at a level where we decide that the childhood mortality/adult shingles incidence is the lesser evil. Going by what’s been see so far, I sort of doubt it. But it’s interesting seeing something like that play out in my lifetime, where things like smallpox, polio, and MMR are ‘historical’ for me.

cjvg

Every medication carries risk, and make no mistake vaccinations are medicines and as such do carry a risk of adverse events!
See my post below on that!

It is never acceptable to mandate that others be forced to take the risk of injury to their body against their believes and against their will. This is the exact same argument the anti-choice uses to force gestation and birth on unwilling women.

I believe that is an amoral stance regardless of the (perceived) benefit for society!

lady_black

Tell that to the military. It’s NOT the same argument as forcing gestation and birth on unwilling women. While I agree that vaccines aren’t without risk, there is a public health concern involved that isn’t there with gestational issues (which by definition involve only one individual). By the way, don’t bother putting words in my mouth, and don’t try sneaking non sequiturs past me. I read what you wrote. The US being at the bottom in child health is irrelevant to our vaccination rates. It doesn’t follow, and I never said it did. Nor did I imply that forcing vaccinations would “fix” this problem. Our dismal record in child health needs a lot more than vaccines to fix it. Other civilized nations have socialized medicine. Therefore the difference in child health would seem to be correlated to the system of health care and availability, and completely disassociated from vaccination rates.

cjvg

I never put words in your mouth. Please bother to read impartially first, without getting in a snit because I do not agree to your view
Would you please stop accusing me of things I never said or even implied!!

My argument is that non vaccination is not the biggest problem the US has when it comes to child health, plenty of other things are the problem here, non vaccination not even being a large enough faction to make it in the top ten of problems causing our abysmal health record

cjvg

When you join the military you give up certain civil rights, since children are not in the military this is not an applicable argument.

bitchybitchybitchy

Is it acceptable for other people and their children to be exposed to, and contract diseases such as measles, mumps, chicken pox and whooping cough because some parents would rather maitain their self-image? I suppose someone’s “self-image” is so much more important than public health.

cjvg

Is it acceptable to make unsubstantiated personal attacks based solely on your believe that your opinion can not be questioned and must be considered the gold standard!

Your need to pass off irrelevant personal attacks as legit argument diminishes your credibility to zero!
Please bring a real rebuttal to the table or I won’t bother addressing this drivel

bitchybitchybitchy

I think that vaccines have a valid role in protecting public health. Why don’t we agree to disagree?

Shan

Because the argument seems to be coming down to: should vaccination be mandated by the government because there’s a “compelling interest” in protecting public health or should parents be able to refuse to vaccinate because, bodily autonomy?

bitchybitchybitchy

As I said we’re going to disagree on this issue.

Renee Goodwin

As long as every non vaccinated child is clearly marked, for example a distinctive hat that signifies that the child is a probable disease vector, along with a number on the hat, that people can jot down when they are exposed to one of the potentially contagious little darlings, and the right to sue the parents if your infant, your family member with a weak immune system, or your fetus is harmed by exposure to their infectious little angel, I would have no problem with the anti-vaccine crowd

bitchybitchybitchy

My concern is that because it is very unusual for children to die from these diseases that people are not truly aware that these diseases used to regularly infect many chidlren, some would die, some would suffer damage to their heath, etc. So, yes, if people genuinely do not want to vaccinate their children, then those people need to accept that they might well be the cause of harm to others.

Renee Goodwin

If you take a close look at historical events outside of wars that had high death rates, a good number of them involved diseases

red_zone

Diseases like measles, polio, mumps and whooping cough are experiencing a resurgence. These diseases are highly contagious and were responsible for epidemics just over half a century ago. Children DIED from them. These are not minor things.

Autism is difficult, but it’s not a tragedy. i have a nephew with autism and he is an absolute joy. He has good days and bad days, like any child and he requires unique care, but he is surrounded by family and friends who love him.

The real tragedy is ignorance and people who believe that autism, a condition that CAN be managed with proper intervention and care, is the worst possible thing that could happen to their child.

No, the ‘worst possible thing’ that could happen to ANY child is that they directly suffer from a parent’s willful ignorance and even negligence. Your ego and stubbornness is NOT worth more than they are.

Renee Goodwin

I think the answer to the increase in autism among children is more likely to be from exposure to chemicals in the environment, the foods the mother ate while pregnant, or people getting better at having it diagnosed (as in it was there all along) then for it to be from vaccines

fiona64

Despite searching on, at times, an industrial scale, since 1996 there
is still no evidence of even a single autistic person within this
group..

May I see a citation, please?

red_zone

I’m not dismissing your concerns or your situation. I’m sorry that your daughter had a bad reaction to the MMR.

The fact remains, these are REAL diseases and people die from them; children are especially vulnerable, or do you need to be reminded of the polio epidemic that happened back in the mid 20th century? How many children died before a vaccine was provided?

Well, NOW because of that selfish idiot who wrote that bogus study, polio is making a comeback. Along with measles, whooping cough and rubella. ALL of which are fatal and of which children are particularly vulnerable to. But because we don’t like everything pharmaceutical does (and i would be one of those people, thank you!), does that mean we should stop vaccinations all together and let those same diseases run rampant again???

And then there was this incident detailed in The Journal of Infectious Diseases published (1991) Between 1985 and 1989 there was a major vaccination drive to eliminate polio. Within 4 months they had a huge outbreak of paralytic polio (350 cases). They decided to reformulate the vaccine (!) since it was concluded that the vaccine was the cause of this particular outbreak.

http://www.ncbi.nlm.nih.gov/pubmed/7468641
Atypical measles syndrome.
Initially this occurred in vaccinated children who where later exposed to wild measles, however it can no be found in children that are vaccinated and where never exposed to wild measles!
There are plenty more examples where these come from!

The FDA is not your friend and at the moment it has neither the moral or ethical standing to make honest decisions for the public at large!